The effect of obesity on chronic kidney disease.

Overweightness and obesity are associated with many hemodynamic, structural, and histopathologic alterations in the kidney and with metabolic and biochemical changes that predispose to these abnormalities. Consequent to these disorders, these individuals are more likely to develop chronic kidney disease and end-stage renal failure. Overweight and obese people are more prone to develop albuminuria and, for at least some types of kidney disease, a greater amount of albuminuria and more rapid progression of renal failure. These individuals are more likely to develop diabetes mellitus and hypertension. Diabetic nephropathy, hypertensive nephrosclerosis, focal and segmental glomerulosclerosis, renal cell carcinoma, and urate and calcium oxalate urolithiasis are the more common kidney and urological diseases reported in obese people. Preliminary data indicate that many of the clinical and nephropathologic manifestations associated with obesity can be reversed or ameliorated with reductions in body fat induced by dietary energy restriction or surgical procedures that reduce intake and gastrointestinal absorption of calories.